Austin Clinical School 50 Year Anniversary

Welcome

A fiftieth birthday is a great reason to celebrate! While the Austin Hospital itself is much older than fifty years, in 2017 we are celebrating the highly successful clinical school partnership between the Hospital and the University that has produced 3,154 medical graduates over the last half century.

Starting with a cohort of 17 students who chose to travel to Heidelberg in 1967, the Austin Clinical School now hosts approximately 190 students each year, spread across the final three years of the MD.

In celebrating the 50th Anniversary of the Austin Clinical School we pay tribute to the pioneering spirit that led to its creation; the strong collegial partnership between the clinicians, teachers, students and administrators that is so important to our mutual success; and the many excellent graduates who have gone on to make a significant difference to the lives of their patients and the health of their communities.

Commemorative Program

On Saturday 8 April 2017, a dinner to celebrate 50 years of clinical education was held in the Great Hall at the National Gallery of Victoria for the Austin Clinical School alumni and staff. A commemorative program was prepared for this event.

The anniversary celebrating 50 years of Medical Education at the Austin is a great opportunity to reflect and share stories of your time at university. This year we called out for past alumnus to share their 'Memories of The Austin'.

I was appointed to the Austin Hospital in July 1967 at the age of 32, following the appointment of Professor Howard Eddey in February of that year. Until 1968, we constituted the University Department of Surgery. The first six months were quite hectic. A course for the incoming students (who started in October 1967) had to be planned. Lectures had to be arranged. Teaching rounds had to be scheduled. This was all in addition to the routine clinical work. Surgical teaching was done by Professor Eddey and me.

On the medical side, Professor Austin Doyle, Dr Bernard Sweet (who was in the same year as me as an undergraduate) and Dr Bill Louis arranged the medical lectures and ward rounds. At the Austin, pathology and microbiology were taught on the hospital campus, unlike the older teaching hospitals where these subjects were taught on the University of Melbourne campus. This meant that integrated teaching in these subjects was facilitated. I did joint sessions with the pathology staff and the microbiology staff. In particular, I did joint ward rounds with the senior lecturer in microbiology. This meant that the practical use of antibiotics on surgical patients was taught at the bedside. This was new to the University of Melbourne.

There was universal enthusiasm from all the new appointees and from the first student group. I think that all staff members recognised an incredible opportunity. The students did also. We were all pioneers. We did not have to follow the age-old traditions of the hospitals whence we came. We had worked overseas and seen the best in the world. We could do our own thing and we did. We did not aim to be as good as the Royal Melbourne Hospital or St Vincent’s Hospital. We aimed to be better. Apart from the two professors the new clinical staff were all in their thirties. We transformed the hospital from “The Austin Hospital for Cancer and the Incurables” into a leading teaching hospital in Australia, which lead the world in several areas. The research output in those early years was incredible, largely due to the efforts of Austin Doyle (Professor of Medicine). Austin Doyle supported me personally as much as he did those in his own Department. My rabbits (on a high cholesterol diet) were housed in a tiny green corrugated tin shed behind a new two-storey brick building which had just been built for the University.

There was no vascular surgeon at the Austin when I was appointed and I was the only one for the next five years. In retrospect, being the sole vascular surgeon for five years gave me an unparalleled opportunity to develop vascular surgery at the Austin in the way I wished. There were no ICU units in Australia at that time although I had seen several in the USA. We had an excellent nurse in charge of our 3KZ block ward, Barbara Carson (she later became Matron of the Austin). I arranged with Sister Carson that a four bed section of the ward be set aside for vascular patients returning to the ward from the operating theatre. I thought that this was very important for my aneurysm patients in particular. The nursing staff in this section developed considerable expertise looking after these patients When Robin Smallwood was appointed Director of Anaesthesia in 1969 he soon set up an ICU adjacent to the operating theatres. My ward ICU became redundant, but I like to think that I started the ICU at the Austin.

I started a separate Vascular Surgery Outpatient clinic in 1970 and a Vascular Surgery Unit when Neil Johnson and Brian Buxton were appointed to the hospital in 1973. Our unit became one of the leading units in Australia. I had been taught in the Professorial unit at St Bartholomew’s Hospital in London, the importance of audit. I kept an audit of all my patients, public and private, throughout my surgical career. This enabled the publication of many papers. I employed a secretary to the vascular unit (at my own expense for several years) to ensure an accurate audit. Eventually, the hospital paid for the secretary.

During my extended visit to the USA in early 1967, I met several surgeons who were “Fellows in Vascular Surgery” in the units to which they were attached Some of these fellows were paid others, others were not. They were full time and the training they received was first class. In Australia there were no positions specifically for vascular surgery training, experience in vascular surgery was part of general surgery training. We were the first in Australia to have a Fellow in vascular surgery. This was highly successful and eventually, this training was adopted throughout Australia, based on the model at the Austin.

We were the first to have a vascular laboratory attached to a vascular surgery unit in Australia. The initial laboratory was a former infant feeding preparation room adjacent to our ward in the 3KZ block. This facility was, of course, expanded with the building of the Harold Stokes block and again later with the Austin/Mercy redevelopment. In the late 1980’s the Medicare fee schedule was to be expanded, a team came from Canberra to inspect our facilities, our staff and our costings as we were the leading Vascular Laboratory in the country. The work in our laboratory led to the publication of many papers. I was the first in the world to use ultrasound to interrogate varicose veins. Several of our fellows worked on this theme and of course, our laboratory did also.

An anecdote I well remember was as follows: In 1979, at an overseas meeting, I heard a presentation about OPG’s (an oculoplethysmograph to measure delay in flow in the carotid artery for detection of carotid artery stenosis). I visited Wesley Moore in Tucson Arizona USA to see how this machine was used. I was most impressed. I purchased the machine with my own money. After return to the Austin, I applied to management for reimbursement of the cost ($8600). This was a lot of money in 1979. After a lot of haggling, the hospital agreed to reimburse me. But they clearly stated, “Never do that again”, However, I had my machine.

My colleagues at the Austin had similar ambitions. When John Dawborn was appointed to the Austin in September 1967, he established a home dialysis program (the first in Australia). As the only vascular surgeon in the hospital, I did all the renal access surgery and so developed a close liaison with the renal unit. This liaison has continued since. When I was on my own, I developed a close liaison with the radiology department. This grew as the volume and complexity of vascular surgery advanced. I think that the liaison between the Radiology department and the vascular unit at the Austin became the best in Melbourne. A similar liaison was developed with the neurology unit. The stroke unit was the first such unit in Australia. Peter Bladin and I both became recognised internationally for our work on stroke patients. Such liaison between physicians and surgeons did not occur at the hospitals we had come from, and I think that this medical-surgical interaction was of great importance to the development of the Austin Hospital. This was seen later in the development of the liver transplant program.

A further anecdote I can remember was this: One morning we had completed the ward round of our patients in the 3KZ block. We were proceeding along the walkway on the first floor towards the main hospital. I looked down and saw two men dressed in black with balaclavas over their heads waving sawn-off shotguns around. They did not spot us as we were on a higher level. I quietly and quickly ushered everyone back into the ward. The NAB branch was in a solitary building immediately adjacent to the east end of the 3KZ block. It was being robbed. The ward clerk promptly phoned the police. She said, “The bank’s being robbed”. When she hung up we realised she had not told the bank, which bank. She was too excited. I do not know whether or not the culprits were caught. I had to take the bank manager to the operating theatre and stitch up a large gaping wound on his bald head, where he had been struck by one of the robbers.

Professor John Royle(Class of 1957)

Dr Howard Stevens (Class of 1970)

At one of the early lectures for the first students of the Austin Hospital Medical School, I recall a lecture by Dr Joan Schiavone who was an entertaining lecturer and teacher. I don't remember the lecture but there was some discussion about smoking and Joan mentioned a patient who was asked if she smoked after having sex. Apparently, the patient answered, rather bemused, that she had never looked!!

On another occasion, there was a surgical ward round in Heidelberg House with David Gillett. The students were around the bed as David was demonstrating some point, but he was not aware that he was repeatedly backing into an Arum lily with a long stamen covered in bright yellow pollen which was prodding him between the legs and leaving a noticeable mark. Eventually, Howard Stevens interrupted "Excuse me sir, but I am afraid that you have just been pollinated"!

Another occasion some fine point of medical explanation was not being followed by Howard Stevens when someone quipped "Oh come on Argyl Robinson!" This needed further explanation to the confused student....... "you're being a slow reacting pupil!"

With fond memories

Dr Howard StevensClass of 1970

Dr Graeme Thompson (Class of 1970)

A few recollections from the very beginning.

The first lecture was given by Professor Harold Attwood (Pathology) and the 17 of us squeezed into a clinical room in “A” Block.

“Inflammation" was the topic and Harold made particular emphasis on the correct spelling - "spelt with a double m". He used chalk on a mobile blackboard - no slides or Powerpoint! He proved to be a wonderful teacher and a mentor to many who became pathologists. His broad Scots accent and wit were features of his teaching.

Fairly soon lectures were held in the lecture theatre of the Leslie Jenner Nurses Home - with slide projection facilities!

The students quarters, now the Medi-Hotel, were under construction when we started and the Edwardian building that now houses the Childcare Centre was both the students quarters and the venue for pathology and microbiology practical sessions for a couple of months.

No recollection of the early days would be complete without reference to Mrs Jean Bright, secretary to the initial Dean, Prof Sir Lance Townsend, and his successors. Jean was a vital cog in running of the clinical school with great organising ability but also was a good listener. She provided great support to the student group, collectively and individually.

An orthopaedic tutorial from John Critchley, Senior Orthopaedic Surgeon, was cut short on July 20th 1969. Critchely said “I’m not going to miss this for anything” and we all went the ward and watched Neil Armstrong take those first steps on the moon.

Graeme ThompsonClass of 1970

Dr Henry Warszawski (Class of 1973)

My time spent at the Austin Hospital provided a vital clinical foundation for a most rewarding career that continues to evolve & flourish to this day.

Dr Henry WarszawskiClass of 1973

Professor Rob Moodie (Class of 1976)

In my 4th year at the Austin (1974)

I dreamed I was being asked a question about Hepatitis B by Professor Ian Gust. I awoke in the front seat of the lecture theatre (not my usual choice of seating) to find out that in fact, I wasn’t dreaming, and that Professor Gust was in very close proximity waiting for an answer. I straightened up, rubbed my eyes, wiped away the dribble and then proceeded to mumble a hastily formed response, in the hope that saying something it might get me off the hook. Unbeknown to me, my “friend" Dave Lindsay was watching all of this from the back row (which is where I should have been). He boomed "I'm sorry Professor I couldn’t quite what that student said, could he please repeat it……."

I had the honour of being asked to join the Remedial Group in my final year in 1976. This resulted from me killing several patients, metaphorically as least, in my final year practice surgical oral exam. I joined such luminaries as Gordon Wallace, Wendy Vanselow and John Salkeld. The Remedial Group was part of the Austin Doyle School of Humiliatory Learning (ADSHL), the ethos of which was acutely demonstrated when in the packed lecture theatre, Professor Doyle said - “Tell me all you know about rheumatoid arthritis Mr Moodie………I know it isn’t going to take long.” Needless to say, it was the ADSHL that got me through final year.

Professor Rob Moodie(Class of 1976)

Dr Simon Madin (Class of 1977)

One that really stands out for me was at the end of our training and I’ll retell it as I remember it. I was in the class of 1977. That was 40 years ago now but I have never forgotten this most important piece of teaching I received at the Austin.

On our very last day as students at the Austin, our Professor of Medicine, the late Austin Doyle, called us all together in the small lecture theatre. He said: "I have something very important to discuss with you. Shortly you will be doctors." He then put this question to us. "What are the three most important things you must do to ensure a successful career in medicine?" Students responded with answers such as: “Place the patient’s head at a 45 degree angle to observe the JVP”, or, “Use the bell of your stethoscope to listen for diastolic murmurs". He said: “No, no, no. "I’ll tell you the three most important attributes of a successful doctor. Number one: communication. Number two: communication. Number three: communication!”

In my nearly 40 years of practicing medicine I’ve never forgotten this important piece of advice. It has helped me enormously and held me in good stead throughout my career. I’ve also passed this sage advice on to the many students and registrars I have had the privilege to teach over the years.

This is an example of what was so inspirational about the Austin Clinical School. We weren’t just taught clinical medicine, we were also taught how to be good doctors.

Dr Simon MadinMBBS FRACGP MPH DRANZCOG ACCAMClass of 1977

Dr Peter Laussen (Class of 1980)

I was fortunate to be at the Austin from 1978 to 1980, when it was still viewed as a young school, and certainly less traditional than the well-established clinical schools at RMH and St.V’s. In truth, it was a wonderful environment for learning. Dr Bernie Sweet was the Dean and always available. The group size really facilitated engagement and the faculty were obviously keen to teach and shape the “next generation”. As I reflect now, I think the most important lessons were to think in an integrative fashion, to not accept things at face value, or simply what may be written, but to appraise the information available, look for gaps and possible questions and/or solutions. The clinical skills from accurate history taking through to meticulous examination were ingrained and have also stood me in great stead since. The most endearing aspect of training at Austin without a doubt are the friendships that were solidified and have remained over many years.

Since graduating in 1980, I have worked at the Austin and RCH, then to Boston for 20 years and now Toronto for the past 5 years. There are many stories I could relate about my time as a student at the Austin, but suffice to say my path was paved by the training I received at the Austin, for which I am forever grateful.

I wish the Clinical School all the best for the next 50 years and hopethat their Alumni enjoy their medicine as much as I still do, fortified bythe humour and catholic experience offered.

Dr Richard Heath FRACGPClass of 1983

Dr Daniel Lane (Class of 1999)

20 years ago I was a 4th year medical student at Austin (1997). The group of four medical students I was in for tutorials and ward attachments was allocated for a surgical rotation to Surg 1. Everyone knew you were on Surg 1 as only Prof Hardy and the 8A nurses strictly enforced the short white coats on the ward rule. Going to liver transplants and retrievals was a bonus of the term but without a passport, at the time the trip on the plane to New Zealand for a retrieval went to someone else in the group. Apparently, the weather was appalling on the flight in a tiny plane over the Tasman Sea and it was a good thing I couldn't go in the end as it was a seriously rough trip.

We were the first group of students to be rotated to The Northern Hospital. After going through 60 sets of traffic lights (I counted them one morning) to get there from home in Doncaster we were astounded to find the hospital had apparently been built in the country given the green fields and the Country Fire Authority station situated nearby in this far-flung location. The little shopping centre next door was the only reminder you were still in Melbourne (and bizarrely paid parking was strictly enforced at this hospital in the middle of nowhere). Hard to imagine it was ever like that now with how the northern suburbs have grown.

Daniel Lane MBBS FANZCAClass of 1999

Assoc Prof Catherine (Kate) Cherry (Class of 1992)

There are so many memories from my time at the Austin that continue to shape my clinical practice and teaching (twenty years on!) – but one name is at the heart of a lot of them. Mary Rose Stewart. As a student I was in awe of her for her for her stylish presence and sheer brilliance. But it was awe without fear – this was a woman who wanted me to become good physician and who showed by example that females could truly be the best in the sometimes cut-throat world of academic medicine.

As her registrar I came to appreciate Mary Rose on many more levels. She taught me the true meaning of holistic patient care with her unique combination of extraordinary diagnostician, compassionate care-giver, wonderful teacher, seeker of evidence, and humanitarian. Who else could I have gone to for non-judgemental help after diagnosing unilateral renal artery stenosis by commencing an ACE inhibitor in a clinic patient? Who else would have offered relationship advice and gardening tips to ground me during a frazzled phone call mid-way through a frantic twenty eight hour shift as Medical Registrar? Or bought me a coffee on her way into the morning round, without having to ask a junior team member how they liked their morning cuppa?

I finished my eight years at the Austin with an excellent grounding in clinical medicine thanks to many fine teachers and mentors. But I left with a great deal more than that. When I bring coffee to the Friday ward round for my team, I think of the woman who taught me that taking time for shared refreshment enhances patient care and team morale. When we identify questions on each round and agree to bring back the current evidence, I can see Mary Rose admitting freely that learning never stops and being happy to be taught by younger staff. I have never needed to question the value of understanding something of each patient’s life since watching Mary Rose provide care that considered more than lab results and examination findings.

I don’t expect I will ever be the great physician Mary Rose Stewart is, but I know her teaching and example has contributed much to whatever skill I have. I mentally thank her for this gift on an almost daily basis.

Just wanted to share a memory of my last clinical exam as a medical student, held in the old Austin outpatient's clinic. With lots of adrenaline, I bumbled through all the stations - got to the last OSCE station - Brendan and Barbara opened the door, and inside, instead of another tricky scenario, there was a big plate of Tim Tams. Best ever!

Dr Harriet GeeClass of 2005

This year we celebrate 50 years of excellence in medical education at the Austin Clinical School. This anniversary will be marked with a series of events throughout the year of which the highlight was the Gala Dinner on Saturday 8th of April at the National Gallery of Victoria.

The Gala Dinner was a fantastic occasion, where enduring connections were celebrated and many fond memories were shared. The conversations reminded us of our collective history and highlighted the diverse contributions Austin graduates have made to the field of medicine.

The evening featured:

Two short films about the Austin Clinical School and alumni

A performance from the Austin Andante String Quartet

Superb food and wine prepared by Melbourne's own Peter Rowland

Short presentations from the new Dean of MDHS, Professor Shitij Kapur and others

Thankfully, the evening was captured in a series of photographs that we take great pleasure in sharing with you via an online gallery. To access the photos please click here.

If you are an Austin Clinical School alumnus and did not receive an invitation we may not have your up-to-date contact details. Please contact us on mdhs-alumni@unimelb.edu.au.

In 1967 the first group of Melbourne Medical School students ventured to Austin Health for their clinical years. They numbered just seventeen. Fifty years later the cohort has grown to over two hundred.

Today the Austin Clinical School is one of the top choices for medical students and an international leader in contemporary clinical education.

A new challenge

Just as it did in 1967, the University of Melbourne still attracts the best and brightest students pursuing their dream of becoming a doctor. Yet in the past fifty years, the increased cost of study and steadily declining support for students has created financial obstacles.

The total cost to complete the four year MD for a full-fee paying student is $282,000

Government assistance only covers the first two years of study

During the clinical years, students are experiencing significant financial pressure

How you can make a difference

The 50th Anniversary of the Austin Clinical School is a time to reconnect with peers, reflect on your shared memories, and celebrate your time at university. A gift to support today’s students at the Austin Clinical School is a powerful way to mark the milestone and ensure that the next generation receive the same transformative experience as you did in your clinical years.